NHS Continuing Healthcare: Eligibility, Assessment and Appeals

NHS Continuing Healthcare is a package of care arranged and funded solely by the NHS for individuals with complex, ongoing healthcare needs. If eligible, all your care costs are covered - even in a care home.

CHC eligibility depends on having a 'primary health need'. This means your main need for care is health-related, not just social care needs like help with washing or dressing.

• Behaviour - challenging behaviours, mental health
• Cognition - understanding, decision-making
• Psychological needs - emotional, mental health
• Communication - ability to express needs
• Mobility - moving around safely
• Nutrition - eating, drinking, swallowing
• Continence - bladder and bowel management
• Skin integrity - pressure sores, wounds
• Breathing - respiratory needs
• Drug therapies - complex medication regimes
• Symptom control - pain management
• Altered states of consciousness - seizures, blackouts

First, a Checklist screening is completed. If positive, a full Decision Support Tool (DST) assessment follows with a multi-disciplinary team. The CCG/ICB then makes the final decision.

You can request a local review within 6 months of the decision. If still refused, you can appeal to NHS England. Consider getting advocacy support for appeals.